NPIMap

Individual provider Active NPI

Ryan D Dehaan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Lincoln, NE
National Provider Identifier
1902882913
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
24093 Issued in NE
Practice address
5440 South St Ste 200
Lincoln, NE 68506-2116
Phone
(402) 465-1900
Fax
(402) 465-1940
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 45701 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 24093 NE Primary

Addresses

Primary practice location

5440 South St Ste 200
Lincoln, NE 68506-2116

Mailing address

5440 South St Ste 200
Lincoln, NE 68506-2116
Phone (402) 465-1900

Other identifiers 1

IdentifierTypeStateIssuer
110164100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070627000616 NE Practitioner - Pathology 7113026410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Kansas School of Med (KC/Wich/Sal), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Medical Services PCGroup PAC ID 0648255265, 13 clinicians

Practice addresses (Care Compare)

5440 S St
Suite 200
Lincoln, NE 68506-2116
Phone (402) 465-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45701MNMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Dec 1, 2021 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Pathology Medical Services PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2007 Accepting new patients
Pathology Medical Services PC CurrentSince Jul 1, 2007 Accepting new patients

Locations

4600 38th St
Columbus, NE 68601
Phone (402) 562-3333

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

5440 South St
Lincoln, NE 68506

5440 South St
Ste 200
Lincoln, NE 68506
Phone (402) 465-1900

1600 S 48th St
Lincoln, NE 68506
Phone (402) 481-9049

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

109 N 15th St
Norfolk, NE 68701
Phone (402) 371-3564

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1902882913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 SOUTH ST STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062116",
            "telephone_number": "402-465-1900",
            "fax_number": "402-465-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SOUTH ST STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062116",
            "telephone_number": "402-465-1900",
            "fax_number": "402-465-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "RYAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "45701",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "24093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110164100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.